6100-20 Partnership Agreement - Licensed Certification Provider

OMB Control Number 2040-0272
Approval Expires 06/30/2013

Partnership Agreement:

Certification Providers

Section I: EPA WaterSense® Program Goals
The WaterSense program aims to use water resources more efficiently to preserve them for future generations and to
reduce water and wastewater infrastructure costs by reducing unnecessary water consumption. Through WaterSense,
EPA provides reliable information on high-performing, water-efficient new homes, raises awareness about the impor­
tance of water efficiency, helps consumers identify new homes that use less water, promotes innovation in residential
construction, and supports state and local water-efficiency efforts.

Section II: Partnership Pledge
As a WaterSense program partner, _________________________________ (name of organization) shares EPA’s goals as
outlined above and is proud to commit to the following activities to further these goals:
1. Meet the responsibilities outlined in the WaterSense new home certification system, including, but not limited to,
certification of new homes and oversight of water-efficiency home inspectors in the United States.
2. Adhere to all policies and procedures contained in the Program Guidelines.
3. Sign and issue the WaterSense label certificate sticker to builders of certified new homes and supply the builder
partner with guidance on proper use of the label and advertisement of WaterSense labeled new homes.
4. Notify EPA quarterly of any new homes that have been certified and labeled using a form provided by WaterSense.
5. Help EPA maintain program integrity by alerting EPA of possible misrepresentation(s) of the certification or pro­
gram marks. Adhere to WaterSense program mark guidelines and ensure that authorized representatives, such as
advertising agencies or subcontractors, also comply.
6. Grant WaterSense permission to include partner’s name, including contact information, on a list of participating
partners on the WaterSense website, program materials, and announcements. Partners understand that from time
to time, EPA will be interested in profiling partner accomplishments in case studies and articles. If selected for such
promotion, partners will have the opportunity to provide input and review the final print or web document before
EPA releases it to the public. Further, the partner understands that EPA might refer media contacts interested in pub­
licizing WaterSense to partners for information about certified new homes and accomplishments.

Section III: EPA WaterSense Program’s Commitments to Partners
1. Develop national specifications for water-efficient homes, products, and programs through an open, public
process. Supply materials related to the inspection and certification of new homes.
2. Increase awareness of the WaterSense brand by distributing key messages on the benefits of labeled new homes,
as well as the importance of water efficiency.
3. Provide current WaterSense program news, information, and reference documents (via the program website,
Helpline, e-mail, or other means), including training materials, inspection checklists, and guidance.
4. Provide WaterSense partners with public recognition for their involvement in the program and role in protecting
the environment through an online listing of partners, special awards, and other efforts.
5. Respond swiftly to partner requests for information or clarification on WaterSense program policies.
6. Provide materials, templates, and program marks for promotional use, consistent with WaterSense program
guidelines.
7. Provide guidelines on appropriate use of the WaterSense label and advertisement of WaterSense labeled new
homes.
8. Review pre-press promotional items, draft websites, or other materials that use WaterSense program marks, upon
request.

EPA Form Number 6100-20

Section IV: General Terms and Disclaimers

1. The partner will not construe, claim, or imply that its participation in the WaterSense program constitutes federal
government (EPA) approval, acceptance, or endorsement of anything other than the partner’s commitment to the
program.
2. Nothing in this agreement, in and of itself, obligates the EPA to expend appropriations or to enter into any con­
tract, assistance agreement, interagency agreement, or incur other financial obligations that would be inconsistent
with Agency budget priorities. The partner agrees not to submit a claim for compensation for services rendered to
EPA or any Federal Agency in connection with any activities it carries out in furtherance of this agreement.
3. The partner and WaterSense will assume good faith as a general principle for resolving conflict and will seek to
resolve all matters informally, so as to preserve maximum public confidence in the program.
4. Failure to comply with any of the terms of this partnership agreement can result in its termination and cessation of
access to the benefits of the program, including use of the program marks.
5. WaterSense will actively pursue resolution of noncompliance related to the use of the program marks.
6. Both parties concur that this agreement is wholly voluntary and may be terminated by either party at any time,
and for any reason, with no penalty. Termination will begin effective immediately upon written notice to or from
the WaterSense program. Upon the termination of this agreement, partners agree to remove program marks in a
timely manner, consistent with the WaterSense program mark guidelines.
To be completed by partner

Authorized Partner Representative1 (printed name): ______________________________________________________
By signing this agreement, I certify that I have been approved by an EPA-approved program administrator and that at
least one quality assurance designee within my organization has attended the required training for certification providers

about WaterSense.

Title: __________________________________________ E-mail: ______________________________________________

Signature: ______________________________________________ Date: ______________________________________
Organization Name:_______________________________________ Website: ____________________________________
Program Administrator: ________________________________________________ Approval Date: ____________________
Primary Contact: Dr./Mr./Mrs./Ms._________________________________________________ Suffix: ________________
Title:_____________________________________________ Dept.: ________________________________________________
E-mail: __________________________________________________________________________________________________

Address: _____________________________________________ City/State/ZIP:__________________________________
Telephone: __________________________________ Alternate Telephone: ____________________________________
Quality Assurance Designee: ______________________________________________________________________________
Telephone: __________________________________ E-mail: ________________________________________________
How did you find out about this program? � Website � Referral, Name: ____________________________________
� Periodical: __________________________ � Workshop, Sponsor: ________________________________________
� Mailing: __________________________ � EPA Region: ________________ � Other:________________________
Please identify where you provide services by county, metro area, or state. ____________________________________
__________________________________________________________________________________________________
To be completed by EPA

Sheila E. Frace
Authorized EPA Representative (printed name): __________________________________________________________

[email protected]
Director, Municipal Support Division
E-mail:______________________________________

Title: __________________________________________________

Signature: ______________________________________________ Date: ______________________________________
1The

authorized partner representative should be a person in the company with signing authority (e.g., vice president).

EPA Form Number 6100-20

Submit the Partnership Agreement (rewriteable PDF) to WaterSense via:
Fax: (703) 841-1440

Mail: WaterSense, c/o ERG, 2300 Wilson Boulevard, Suite 350, Arlington, VA 22201

Electronically: If you have Adobe Acrobat, you can complete the form electronically and e-mail it to: [email protected].

Please contact the WaterSense Helpline at (866) WTR-SENS (987-7367) if you have any questions about eligibility,

partnership, or for general program inquiries.

After signing, EPA will send partners an executed copy of this agreement.

The public reporting and record keeping burden for this collection of information is estimated to average two hours per response. Send comments on the Agency's
need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including through the use
of automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Avenue, NW,
Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed partnership agreement to this address.

EPA Form Number 6100-20